Nontraumatic lower extremity amputation most often occurs as a result of a diabetic foot problem, skin ulcers. The development of skin ulcerations on a patient with diabetes can be caused by any number of things. Some include, pressure from poorly fitted shoes and trauma to the foot and toes. Patients with Peripheral Neuropathy are more likely to develop ulcers because they have loss the sensation in their feet. Most times they will simply notice stains on their socks and footwear.

Unfortunately, even those diabetic patients who take all the proper steps in maintaining their foot care can still get an ulcer. An ulcer is the primary opening for infection that can affect both the soft tissue and the bone. It is very important to stay off your feet once you notice your ulcer. Continuing to walk on it will cause the infection to spread and penetrate deeper into your foot. Delayed treatment of diabetic ulcers can lead to amputation and even mortality

Debridement of the wound is the first steps in treating this condition. Thick layers of skin (corns and calluses), which should be carefully removed until a satisfactory border is present, may cover ulcers. Your podiatrist may require that you wear special footwear, have a culture done, or get x-rays. Additional treatments for ulcers other than local wound care include hyperbaric oxygen (HBO), growth factors, and electrical stimulation. Even after successful treatment, there is a very high probability of reoccurrence. Continue to thoroughly inspect your feet and see your podiatrist on a regular basis.

As usual, Dr. Horsley recommends that all diabetics:

1. Become educated on diabetic foot care
2. Wash and dry feet thoroughly
3. Inspect your feet daily (or have someone else do it for you)
4. Wear properly fitting shoes
5. Wear seamless socks
6. Do NOT walk around barefoot
7. Visit your podiatrist regularly